Bladder Stones Bladder stones are hard calcified masses found in the urinary bladder. They are composed of solidified minerals found in the urine that gradually build up over time and form stones. They are painful and cause discomfort to the patient and also block the urine outflow or bladder emptying.
Associated Anatomy of Bladder Stones
Urinary bladder, kidney, ureter
Causes of Bladder Stones
It has several underlying causes, which include:
- Benign hyperplasia of the prostate: This condition puts pressure on the urethra and causes incomplete emptying of the bladder.
- Nerve damage in the bladder or neurogenic bladder: It disrupts the functioning of the bladder.
- Post bladder surgery: It causes injury to the bladder tissues.
- Bladder diverticula: Abnormal sac-like formations in the bladder cause the stoppage of urine outflow.
- Cystocele: The wall of the bladder pulls down in the vagina and creates pressure on the bladder.
Signs and Symptoms of Bladder Stones
Most of the time, bladder stones remain asymptomatic and don't cause any discomfort to the patient. If the stones are tiny, they pass out through urine easily. However, large stones cause pain and discomfort to the person and if neglected can cause bladder tumour also. Some other symptoms include:
- Pain: Severe (stabbing) pain occurs while urinating and in the abdominal region, including the genitals.
- Increased frequency of urination: It occurs because of incomplete emptying of the bladder.
- Urinary tract infections (UTIs): It occurs because of urine staying in the bladder for a long duration causing repeated infections.
- Presence of blood in the urine: It occurs because of a laceration of the bladder wall.
Diagnosis of Bladder Stones
The doctors can diagnose bladder stones through various tests, which include:
- Urine examination: It analyzes the presence of infections and minerals in the urine sample.
- Cystoscopy: In this test, a small endoscope is inserted into the bladder to directly look at the stones in the bladder through a small camera.
- Intravenous pyelogram: This test checks the presence of stones and other structures like kidneys, ureters, bladder.
Typical Test to Diagnose Bladder Stones
Lower abdominal imaging like X-rays, CT scans, flexible cystoscopy and ultrasound evaluate the presence, size, and exact location of the bladder stones.
Possible Treatment for Bladder Stones
If bladder stones are tiny, drinking plenty of water is recommended to pass them through urination.
Taking alkalizers with water also dissolutes uric acid stones to some extent. However, the overuse of alkalizers can be harmful and can further lead to the formation of calcium phosphate stones in the bladder.
With large stones, cystolitholapaxy is one of the common procedures for removing bladder stones. It removes the stones by breaking them into smaller fragments using laser or ultrasonic methods.
In case of very large stones key hole surgery of the bladder is done to remove the stones.
Risk Factors of Bladder Stones
- Gender: Males are more prone to bladder stones than females.
- Age: Chances of bladder stones increase after 50 years.
- Benign hyperplasia of prostate (BHP): A condition occurring in elderly men that causes the enlargement of the prostate gland.
- Bladder surgery: Any surgical procedure done to treat urinary incontinence increases the risk of bladder cancer.
Primary Prevention for Bladder Stones
There is no way to prevent the occurrence of bladder stones. If you have issues associated with the prostate, like delayed emptying of the bladder after urination, you can consult your doctor so that you don’t develop bladder stones. For people with UTIs, it is always recommended to double void your bladder so that there is no urine left in the bladder after urination.
Secondary Prevention for Bladder Stones
Drinking a lot of water can help prevent the formation of stones by making the urine less concentrated in people who are at risk of developing bladder stones.
Differential Diagnosis of Bladder Stones
Bladder stone pain can resemble a lot with other similar conditions like:
- Urinary tract infection
- Kidney stones
- Urothelial carcinoma
- Prostate enlargement
Bladder Stones Epidemiology
The incidence of bladder stones is increasing in developing countries because of dietary changes and dehydration. Deficiency of vitamins and the intake of fatty diets are associated with the risk of developing bladder stones. In India, 1-19% of the population has bladder stones. It is more common in men over the age of 50 years.
Prognosis of Bladder Stones
With treatment advancement, bladder stones are treated effectively with minimally invasive surgical procedures. Moreover, the treatment of enlarged prostate is recommended in patients having a history of urinary bladder stones to prevent a recurrence.
Natural Progression of Bladder Stones
If left untreated, bladder stones grow in size and create issues like urinary tract infections, pain, bleeding, and discomfort during urination. They also lead to chronic damage to the bladder muscles, thus making them weak.
Bladder Stones Pathophysiology
Bladder stones, just like kidney stones, form because of excess calcium oxalate, calcium phosphates, and uric acid in your urine. This build-up of crystals further speeds up if you have some issue in bladder emptying.
Possible Complications of Bladder Stones
- Urinary tract infections (UTI): Increased frequency of UTIs in the cases of bladder stones, if not treated on time.
- Urethritis and bladder cysts
- Bladder cancer
Our BLK-Max Medical Experts
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